Provider Demographics
NPI:1700898111
Name:ZITZMAN, SHARON ANITA (RPH)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:ANITA
Last Name:ZITZMAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8215 DAVIS LN
Mailing Address - Street 2:
Mailing Address - City:GODFREY
Mailing Address - State:IL
Mailing Address - Zip Code:62035-3075
Mailing Address - Country:US
Mailing Address - Phone:618-466-3746
Mailing Address - Fax:
Practice Address - Street 1:2601 STATE ST
Practice Address - Street 2:
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:62002-5151
Practice Address - Country:US
Practice Address - Phone:618-466-5633
Practice Address - Fax:618-466-5695
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist